O,G&P

YEAR V MBChB Programme (500 Level)
CLI 501 – OBSTETRICS AND GYNAECOLOGY
This programme is undertaken by medical students who have successfully completed the 400 level programme. The course CLI 501 incorporates both CLI 501(A) – Gynaecology and CLI 501(B) – Obtestrics, as the two courses are closely interrelated.
Course Duration: The course runs continuously per group of rotating students for a period of 14 weeks which are usually utilized as follows:
1. Didactic Lecture Period: Two weeks with contact hours of 72 hours.
2. Clinical Rotation in the Teaching Hospital Units for Ten weeks (minimum contact Hours 800
hours).
3. Revision Period – One week (contact Hours – 40 Hours).
4. End of Posting Examinations – One week

Each student is expected to participate fully in the activities of the department, and 75% attendance at the various activities is a pre-requisite for admission to examinations. Moreover, each student is expected to have a minimum of 700 contact hours (Each student is expected to sign attendance registers).

Course Aims/Objectives: The couse exposed the students to broad fields of general gynaecology, obstetrics and foeto-maternal medicine, Upon completion of the course, the student should be able to come up with intelligent assessment of gynaecological and obstetric problems, handle routine office gynaecological problems and demonstrate familiarity with simple procedures in gynaecology and obstetrics.

Course Content: This course is a clinical posting rotation. It consists of lectures, conferences, seminars and intensive clinical exposures, bedside teaching and call duties. The student learns, under close supervision, appropriate patient’s clerking, physical examination and ordering of investigations, including their interpretation. He/She also learns how to initiate and carry out appropriate therapeutic measures and procedures, following general principles of obstetrics and gynaecology and departmental management protocols. The areas to be covered include General Obstetrics and Gynaecological Endocrinology, Urogynaecology, medical disorders in pregnancy, Perinatology, Infertility and Family Planning, Adolescent gynaecology, Sexual Transmitted Infections, including Human Immunodeficiency virus infection and other aspects of Reproductive Health and rights. Modern diagnostic procedures and minimally – Invasive procedures would also be highlighted. The student is regarded as an “Assistant House Officer” during this rotation.
Schedule of Didactic Lectures (Two Weeks)
S/N
9.00 a.m. – 1.00 p.m.

2.00 p.m. – 6.00 p.m.

1.

Introductory Lectures

Modern diagnostic procedures in obstetrics and gynaecology

2.

General obstetrics and gynaecology I

General obstetrics and gynaecology II

3.

High risk Obstetrics I

High Risk obstetrics II

4.

Community obstetrics I

Perinatal medicine

5.

Urogynaecology

Gynaecological Oncology

6.

STIs, HIV, AID

Farmily Planning

7.

Infertility

Assisted Reproductive Techniques

8.

Prenatal diagnosis

Medical disorders in obstetric practice

9.

Reproductive health and rights

Gynaecological endocrinology

10.

Minimally-invasive procedures

Adolescent gynaecology

Schedule of Students Rotation:

I. Lecture Series:
The first two weeks of the clinical posting is devoted to didactic lectures scheduled as
above.
II. Hospital Postings:

Following completion of the lecture series, each student is expected to rotate through Ife State Hospital, Ile-Ife, and Wesley guild Hospital, Ilesa (which are the main hospital units of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife

Consultants Staff
The Clinical work of the department takes place in 2 hospital settings, Ife Hospital Unit, Ile-Ife and Wesley Guild Hospital, Ilesha.
There are 13 full time consultants in the department of Obstetrics and Gynaecology. 6 Professors, 2 readers, 4 Senior Lecturers and 2 lecturers 1.
Obstetrics and Gynaecology Academic Staff
1. Prof. O. Kuti – Professor/Consultant and
Head of Department
MBBS,FWACS,FMCOG
FRCOG

5.1 Reproductive Endocrinology and Infertility Unit
The unit is one of the five service units of the department consisting of three consultant staff and resident doctors who rotate through the unit as part of their postings.

The Director of this unit is Dr. A. T. Owolabi and other consultants include Prof. Fasubaa and Dr. O.M. Loto. The unit is at the forefront of establishing a state of the art Assisted Conception Unit (ACU) at the Obafemi Awolowo University Teaching Hospitals Complex. Although the ACU is yet to take off fully, the unit has already started performing less complex procedures aimed at improving the chances of conception among infertile couples following their investigations.

Some of the procedures currently being performed at the unit include the following:
1. Thorough evaluation of the infertile couples including investigations such as HSG, Laparoscopy and dye test, semen analysis etc.
2. Ovulation induction with either clomiphene citrate or gonadotropins with ultrasound folliculography.

3. Intrauterine Insemination (IUI) with washed semen for patient with mild to moderate oligospermia and unexplained infertility using swim up technique or density gradient.

The unit has just been given a space in WGH Ilesa to be devoted entirely to ovulation monitoring, sperm preparation and intrauterine insemination (IUI) of washed semen. This procedure is also carried out as an outpatient procedure in Gynaecology clinic at Ile-Ife and at the departmental laboratory in the University.
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At the Obafemi Awolowo University, the department has a standard gynaecology laboratory which is well equipped with andrology facilities both for the training of the students/residents as well as service to our clients. This laboratory is in the process of being upgraded.

The department is currently seeking for partners so as to upgrade our unit to a full fledged assisted conception unit where we will be able to perform in-vitro fertilization and embryo transfer (IVF-ET) as well as intracytoplasmic sperm injection for severe male factor infertility. We are pioneering prostaglandin and free radical research in human semen and trace elements supplementation as a means of correcting oligo spermia in African males.

Funding is our major challenge and the department hopes to overcome this with more decisive move at all cost within the next few of months.

5.2. Family Planning, Reproductive Health and Community Obstetrics Unit

The Director of this unit is Dr. Mrs. Ijarotimi. This unit organizes and carries out services in the area of Family Planning, Reproductive Health and Community Obstetrics.

The family planning services are rendered to clients at the Ife Hospital Unit, Wesley Guild Hospital Unit, and Urban Comprehensive Health Unit, Eleyele. Contraceptive services such as implants, IUCD, injectables, oral contraceptive pills, condom, etc are rendered in these services. Resident doctors, medical students and student midwives undergo training and rotation in these units. Researches are also being carried out in this unit.

Community services and reproductive health services are also rendered by the members in this unit at the peripheral health centres such as Enuwa maternity entre, Gbelefefe Maternity centre, and Isokun maternity centres. The staff there had been trained in partograph usage in labour monitoring and nutritional supplement in pregnancy to reduce low birth weight.

Collaboration exists between the department of Obstetrics and Gynaecology with Department of Community Health and Institute of Public Health in carrying out research activities in reproductive health and community obstetrics.

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5.3. Feto maternal Medicine (Perinatology Unit)

This unit has 4 consultants: Prof. S.O. Ogunniyi, Prof. O. Kuti, Dr. O.N. Makinde and Dr. A.B. Adeyemi. Prof. O. Kuti directs this unit. Activities of this unit at the moment include
1.Fetal Assessment Clinics for all cases of suspected IUGR and other high risk pregnancies at Wesley Guild Hospital, Ilesa and Ife State Hospital, Ife.
1.Perinatal Bereavement Support clinic at West Guild Hospital Ilesa.
1.Joint monthly perinatal audit meeting

This unit has up-to-date facilities to monitor fetus at risk. The fetal assessment rooms have cardiotocographic monitors and ultrasounds. There is an ultrasound with a vaginal probe at Ilesa and efforts are being made at the moment to replace the present ultrasound in our labour ward at Ile-Ife. There is also a monitoring machine that is more sensitive than the conventional oxymeter that we use for all our high risk patients in the labour ward and ASA 4/5 surgical patients at the labour ward in IHU

5.4 Gynae-Oncology Unit
The Gynae-Oncology unit was created in 2006. It has 3 Lecturers (Prof. Uche Onwudiegwu, Prof. E.O. Orji and Dr. K.O. Ajenifuja) and two Nurses and a Social worker. The unit is equipped with cryotherapy machines, LEEP and colposcopes.
The unit carries out screening for cervical premalignant lesions with direct visualization of the cervix and cytology both convectional and liquid-based.
Screened positive women have their results confirmed by additional investigations such as Colposcopy and directed biopsies.
Women who were diagnosed as having cervical premalignant lesions are treated with either on out-patient basis using cryotherapy or Loop Electrosurgical Excision Procedure (LEEP).
We also offer in patient management such as cone biopsies.

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Bearing in mind that there is little awareness about cervical cancer in the community the unit has outreach program which takes members of the unit to religious organizations and to market women. The objective of the outreach program includes sensitizing the community and increase awareness about cervical cancer and that it is largely preventable if women are screened regularly. We also dispels the myths and superstitions about cancer generally and cervical cancer in particular.
The unit manages other Gynae Oncology cases that are referred to it from time to time and collaborates with other health care deliverers in haematology, morbid anatomy and Gastroenterology oncologist in the care of patients.
5.5 Uro-Gynaecology/General Gynaecology – IHU & WGH – This unit is directed by Prof. F. Dare and Dr. O.O. Badejoko with other members of the team providing services in General Gynaecology and Urological Problems related to Gynaecology.